The Darkest Stretch of the Pandemic Is Here

Today the United States blew by two grim pandemic milestones. The country recorded a record 195,695 coronavirus cases and reported 100,226 hospitalizations, passing the 100,000 mark for the first time, according to the COVID Tracking Project at The Atlantic. While the 2,733 deaths today did not break the all-time record, this was the first day since May with more than 2,500 deaths, as well as the day with the second-most deaths so far. (By The New York Times’ methodology, today’s was the highest daily coronavirus death toll on record.)

These shocking numbers came on the same day that CDC Director Robert Redfield warned that this winter could be “the most difficult time in the public-health history of this nation” and as public-health experts await signs of a post-Thanksgiving surge. Some of today’s increase can be attributed to the numbers catching up after an expected holiday data lag, but it’s also reflective of a bad reality that is poised to get a lot worse as pandemic winter comes into view.

Daily case numbers and death tolls can exaggerate short-term trends because the numbers can be volatile; hospitalizations, much less so. The reasons are pretty simple. Case numbers depend on people deciding to get tested, and there’s evidence that demand for tests increased right before Thanksgiving and then quickly fell off on and right after Thanksgiving Day. The labs that process the tests slowed down at the same time. Death counts also decreased during the holiday, just as they have slowed on weekends throughout the pandemic. Hospitalizations take no such break, because of their urgency: People have less choice in seeking treatment for severe cases than in getting tested, and hospitals have to take those patients as they arrive.

[Read: Pandemic data are about to go sideways]

These patterns are evident in the data over the past week. Daily cases were at 194,804 on November 27, fell to 135,172 on November 29, and now are back over 195,000. Daily deaths were at 2,288 on November 25, fell to 803 on November 29, and now are over 2,700. But hospitalizations have been far steadier: They hit 90,481 on November 26, declined to 89,834 on November 27, and have increased each day since to break 100,000.

That’s why hospitalizations are a good number to watch for the most stable view of the situation. As the numbers start to straighten out, we’ll soon have a sense of the magnitude of the post-Thanksgiving surge. (Any surge in cases will be apparent in the coming days, while a surge in deaths may not be clear until the beginning of the new year.) But the hospitalization trend is the clearest, especially at this particular moment, and the trend is very bad. Today’s new case and death numbers tell the same story, even keeping in mind that they reflect inevitable delays in reporting: A harsh winter is only just beginning.